The book describes the life of Nobel Prize winner John Nash. This Princeton researcher earned his prize from early life work in game theory - mathematics that inform present day economists about market behavior. Mr. Nash coexisted at Princeton with notables such as Albert Einstein. But after his great discovery, his mind plunged into schizophrenia.

At the time, not much was understood about the condition. So the therapies were experimental at best, and highly damaging in some cases. Dr. Nash is one of the few schizophrenics to come out of that period with some semblance of sanity not aided by modern antipsychotics. His son - also brilliant - unfortunately also succumbed to the psychiatric condition and didn't do nearly as well with his life.

I mention this book and Grossman's book On Killing as great reading material if you want to understand this series now being published in The Wall Street Journal. It is both informative and sad. The good news though is society no longer sweeps PTSD patients under the rug where we don't have to witness their "unfortunate" conditions. These heroes are getting the attention and therapy that they deserve, thanks largely to both a better understanding of the human mind vs. killing and the ability to manipulate brain chemistry.

- Bill

WSJ wrote:

PART ONEForgotten Soldiers

Roman Tritz’s memories of the past six decades are blurred by age and delusion. But one thing he remembers clearly is the fight he put up the day the orderlies came for him.

“They got the notion they were going to come to give me a lobotomy,” says Mr. Tritz, a World War II bomber pilot. “To hell with them.”

The orderlies at the veterans hospital pinned Mr. Tritz to the floor, he recalls. He fought so hard that eventually they gave up. But the orderlies came for him again on Wednesday, July 1, 1953, a few weeks before his 30th birthday.

This time, the doctors got their way.

The U.S. government lobotomized roughly 2,000 mentally ill veterans—and likely hundreds more—during and after World War II, according to a cache of forgotten memos, letters and government reports unearthed by The Wall Street Journal. Besieged by psychologically damaged troops returning from the battlefields of North Africa, Europe and the Pacific, the Veterans Administration performed the brain-altering operation on former servicemen it diagnosed as depressives, psychotics and schizophrenics, and occasionally on people identified as homosexuals.

The VA doctors considered themselves conservative in using lobotomy. Nevertheless, desperate for effective psychiatric treatments, they carried out the surgery at VA hospitals spanning the country, from Oregon to Massachusetts, Alabama to South Dakota.

The VA’s practice, described in depth here for the first time, sometimes brought veterans relief from their inner demons. Often, however, the surgery left them little more than overgrown children, unable to care for themselves. Many suffered seizures, amnesia and loss of motor skills. Some died from the operation itself.

Mr. Tritz, 90 years old, is one of the few still alive to describe the experience. “It isn’t so good up here,” he says, rubbing the two shallow divots on the sides of his forehead, bracketing wisps of white hair.

The VA’s use of lobotomy, in which doctors severed connections between parts of the brain then thought to control emotions, was known in medical circles in the late 1940s and early 1950s, and is occasionally cited in medical texts. But the VA’s practice, never widely publicized, long ago slipped from public view. Even the U.S. Department of Veterans Affairs says it possesses no records detailing the creation and breadth of its lobotomy program.

When told about the program recently, the VA issued a written response: “In the late 1940s and into the 1950s, VA and other physicians throughout the United States and the world debated the utility of lobotomies. The procedure became available to severely ill patients who had not improved with other treatments. Within a few years, the procedure disappeared within VA, and across the United States, as safer and more effective treatments were developed.”

Musty files warehoused in the National Archives show VA doctors resorting to brain surgery as they struggled with a vexing question that absorbs America to this day: How best to treat the psychological crises that afflict soldiers returning from combat.

Between April 1, 1947, and Sept. 30, 1950, VA doctors lobotomized 1,464 veterans at 50 hospitals authorized to perform the surgery, according to agency documents rediscovered by the Journal. Scores of records from 22 of those hospitals list another 466 lobotomies performed outside that time period, bringing the total documented operations to 1,930. Gaps in the records suggest that hundreds of additional operations likely took place at other VA facilities. The vast majority of the patients were men, although some female veterans underwent VA lobotomies, as well.

Lobotomies faded from use after the first major antipsychotic drug, Thorazine, hit the market in the mid-1950s, revolutionizing mental-health care.

The forgotten lobotomy files, military records and interviews with veterans’ relatives reveal the details of lives gone terribly wrong. There was Joe Brzoza, who was lobotomized four years after surviving artillery barrages on the beaches at Anzio, Italy, and spent his remaining days chain-smoking in VA psychiatric wards. Eugene Kainulainen, whose breakdown during the North African campaign the military attributed partly to a childhood tendency toward “temper tantrums and [being] fussy about food.” Melbert Peters, a bomber crewman given two lobotomies—one most likely performed with a pick-like instrument inserted through his eye sockets.

And Mr. Tritz, the son of a Wisconsin dairy farmer who flew a B-17 Flying Fortress on 34 combat missions over Germany and Nazi-occupied Europe.

The VA documents subvert an article of faith of postwar American mythology: That returning soldiers put down their guns, shed their uniforms and stoically forged ahead into the optimistic 1950s. Mr. Tritz and the mentally ill veterans who shared his fate lived a struggle all but unknown except to the families who still bear lobotomy’s scars.

Mr. Tritz is sometimes an unreliable narrator of his life story. He describes himself as “mentally injured, not mentally ill.” For decades he has meandered into delusions and paranoid views about government conspiracies.

He speaks lucidly, however, about his wartime service and his lobotomy. Official records and interviews with family members, historians and a fellow airman corroborate much of his story.

It isn’t possible to draw a straight line between Mr. Tritz’s military service and his mental illness. The record, nonetheless, reveals a man who went to war in good health, experienced the unrelenting stress of aerial combat—Messerschmitts and antiaircraft fire—and returned home to the unrelenting din of imaginary voices in his head.

During eight years as a patient in the VA hospital in Tomah, Wis., Mr. Tritz underwent 28 rounds of electroshock therapy, a common treatment that sometimes caused convulsions so jarring they broke patients’ bones. Medical records show that Mr. Tritz received another routine VA treatment: insulin-induced temporary comas, which were thought to relieve symptoms.

To stimulate patients’ nerves, hospital staff also commonly sprayed veterans with powerful jets of alternating hot and cold water, the archives show. Mr. Tritz received 66 treatments of high-pressure water sprays called the Scotch Douche and Needle Shower, his medical records say.

When all else failed, there was lobotomy.

“You couldn’t help but have the feeling that the medical community was impotent at that point,” says Elliot Valenstein, 89, a World War II veteran and psychiatrist who worked at the Topeka, Kan., VA hospital in the early 1950s. He recalls wards full of soldiers haunted by nightmares and flashbacks. The doctors, he says, “were prone to try anything.”

When World War II began, the U.S. military thought it knew how to stave off the psychiatric issues that had ravaged men in the trenches in the previous world war. It began screening potential recruits for psychological trouble signs and ultimately rejected some 1.8 million American men for World War II service on that basis.

Nevertheless, the military and VA soon found their hospitals overflowing. A 1955 National Research Council study counted 1.2 million active-duty troops admitted to military hospitals during the war itself for psychiatric and neurological wounds, compared with 680,000 for battle injuries.

Desperate for an effective treatment for the worst-off patients (including some mentally ill World War I veterans) the VA embraced lobotomy. At the time, tens of thousands of the procedures were being performed in civilian hospitals, a wave inspired by two of lobotomy’s most avid promoters, neurologist Walter Freeman and neurosurgeon James Watts.

“In practical use, the operation has been found of value in eliminating apprehension, anxiety, depression and compulsions and obsessions with a marked emotional content,” VA Assistant Administrator George Ijams wrote to his boss in July 1943, urging the agency to approve the procedure.

Within a month, VA headquarters set guidelines. It ordered doctors to limit lobotomies to cases “in which other types of treatment, including shock therapy, have failed” and to seek permission of the patient’s nearest relative.

In the late 1940s and early 1950s, there existed no diagnosis of post-traumatic stress disorder, a term that came into vogue after the Vietnam War. Back then, the term was “shell shock” or “battle fatigue.” Many lobotomy patients, however, exhibited symptoms that might now be classified as PTSD, says Dr. Valenstein, the former VA psychiatrist.

“Realistically looking back, the diagnosis didn’t really matter—it was the behaviors,” says psychiatrist Max Fink, 90, who ran a ward in a Kentucky Army hospital in the mid-1940s. He says veterans who couldn’t be controlled through any other technique would sometimes be referred for a lobotomy.

“I didn’t think we knew enough to pick people for lobotomies or not,” says Dr. Fink. “It’s just that we didn’t have anything else to do for them.”

In a standard lobotomy, a surgeon pulled back the forehead skin, sawed two holes in the skull and inserted a rotating tool or spatula-like knife. The surgeon then severed pathways between the prefrontal area behind the forehead, and the rest of the brain. These fibers were thought by practitioners to promote excessive and compulsive emotions.

Dr. Freeman, the neurologist who popularized lobotomies, also pioneered a more controversial technique in which he hammered an ice pick beneath the upper eyelid, through the thin bone of the eye socket and into the brain. He would make the cuts by toggling the pick.

Immediately after his return from England, Mr. Tritz seemed healthy enough to his sister, Regina Davis, now 83. By the late 1940s, his behavior became alarming.

Their parents worried Mr. Tritz would attack Regina, according to medical records. “He had voices telling him that maybe he should come into one of the other rooms where one of us might be,” says Mrs. Davis, who lives in Chilton, Wis. “What he had in mind, I don’t know.”

Mr. Tritz’s sister-in-law, Dorothea, remembers visiting the family farm in 1949 and noticing something amiss. To this day, she recalls an exchange she had with Mr. Tritz.

“How are you doing?” she asked.

“Does anybody really care?” she remembers him saying.

Mr. Tritz complained of being persecuted by the Federal Bureau of Investigation and the Air Force, medical records show. Relatives tried to persuade him the conspiracies were imaginary. The senior Tritzes, devout Catholics, took him to a priest.

“The family is quite worried that patient might, because of his thoughts, commit a mortal sin and be damned to eternal hell,” a VA medical report said. The priest sent him to a Catholic psychiatrist, who recommended electroshock therapy.

In 1949, Mr. Tritz's parents had him committed to the VA hospital in Tomah, which specialized in psychiatric cases. They struggled with the decision, according to Mrs. Davis. “I think that’s partly why my mom and dad felt it best that he be committed—for the safety of the family,” she says.

Medical records describe his insulin shock treatments, electroshock and the high-pressure water sprays. “Sometimes the patient would be very alert and would respond immediately when spoken to, and other times would continue to stand in place and grimace as [if] he had never been spoken to, apparently anticipating the shock of the cold water as it hits his body,” medical staff reported in 1952.

“Condition improved slightly,” the staff concluded.

Within months, doctors began to build a case for lobotomy. During one examination, a brain surgeon reported that Mr. Tritz stared straight ahead, refused to speak, turned his arms and hands “in various bizarre positions,” and seemed to be hearing voices.

One neuropsychiatrist warned Mr. Tritz might not get great results from the surgery. “I doubt that social rehabilitation will follow,” she wrote. It is unclear from the records whether such doubts were shared with the Tritz family.

Mr. Tritz’s father authorized the lobotomy, and his mother signed as witness.

Among the VA staff who recommended the Tritz lobotomy was David Merrell, then a 29-year-old psychology doctoral candidate and VA trainee. In a 1953 report he said a lobotomy for Mr. Tritz “should be helpful in lowering the intensity of the disrupting emotional impulses and enable the patient to function more efficiently.”

Dr. Merrell himself had served as a medic during the bloody Allied landing at Anzio, Italy, in 1944. For years after the war, his night terrors would jolt his wife, Ivy, from her sleep.

Now 88, Dr. Merrell remains troubled by his role in Mr. Tritz’s case, the only lobotomy he recommended before leaving the VA. “Looking back at it, it was a terrible thing that came out of the psychiatric medical field at the time,” he says of lobotomy. “But it did allow for control of hospital patients—aggressive, combative patients—without having to hurt them.”

At the time, Mrs. Merrell, 81, was a psychiatric nurse at Tomah, where she worked on the violent ward, playing cribbage and softball with psychotic vets. “I wasn’t a believer back then, and I’m not a believer now in lobotomies,” she says. “I didn’t like the fact that you were messing with somebody’s brain that was already messed up.”

“These patients as a group remind me of a watch that has stopped,” Jay Hoffman, a psychiatrist, wrote in 1949 of 42 veterans lobotomized at the VA hospital in Bedford, Mass. “If one shakes it vigorously the watch is apt to tick a few times, and the tick sounds like that of a watch in good repair, but it runs down almost immediately and stops.”

In 1949, the VA distributed a 37-point take-home guide for families—a pamphlet that, in essence, warned a soldier’s relatives that the man they sent to war was returning to them a child. “He may say anything that ‘pops into his head,’ thus embarrassing you,” the pamphlet says. “Like a young child he may say, ‘I won’t’ to everything you suggest. If you will joke with him, offer him something new, talk about something else, he will probably forget his ‘I won’t.’”

The lobotomized vet might masturbate openly or “bathe or play in the tub for hours and at the same time may not get himself clean.”

“When will he be well?” the VA asked. “We cannot answer this question.”

The VA did try to determine whether the benefits outweighed the risks. And the risks were severe. Overall, 8% of lobotomized veterans died soon after the operation, according to a 1947 document. One hospital reported a 15% fatality rate.

It wasn’t until the mid-1950s that the VA finished a five-year study of 373 veterans. Half were given lobotomies and the rest served as experimental controls. But by the end of the study, many of the test subjects were taking new antipsychotic drugs, muddling the conclusions.

http://www.youtube.com/watch?v=OVykvRkrwBwI discovered some of these videos while writing a paper on the trenches in WWI.Hard to forget them after seeing them.

Thank you for this, Fred. Boy... it drives the point home, doesn't it?

This is actually two subjects in one video.

The former shows severe cases of PTSD - likely with lifelong consequences. To be fair, some are genetically predisposed to a plunge into schizophrenia. Both Nature and Nurture come into play. But the constellation of symptoms shown is dramatic.

The latter shows a shocking ignorance of the fallout from nuclear explosions. Yes... we subjected our own troops to massive radiation exposure. We didn't know, but... Those men observing the explosion nearby and then actually walking towards the explosion undoubtedly lived shorter lives and died horrible deaths. One account I read speaks of a man who put his hands in front of his eyes during the explosion, and saying he could see the bones in his hand when the first electromagnetic pulse transpired.

The video Fred supplied reminds me to bring this condition to the table as well. This is a bit different from PTSD (Post Traumatic Stress Disorder), and not a consequence of overriding our instincts not to kill a fellow man.

This is the kind of thing a full-contact martial artist puts himself at risk for. And for those kyusho people out there who take great pride in counting the number of KOs they've done in their seminars (no names mentioned...), DON'T DO THAT!

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